'If this place wasn't here, I'd be dead'

There were - and still are - doubters who dismissed the Bosman as a crazy, unworkable idea. And who could blame them? The old hotel on Howe Street was refurbished in 2010 to hold 100 of the most difficult-to-house people on the streets, most of them with severe mental illness and drug addictions.

By Vancouver SunNovember 28, 2012

There were - and still are - doubters who dismissed the Bosman as a crazy, unworkable idea. And who could blame them? The old hotel on Howe Street was refurbished in 2010 to hold 100 of the most difficult-to-house people on the streets, most of them with severe mental illness and drug addictions.

It sounded zany, like a recipe for disaster.

But the Bosman has been in operation now for two-and-a-half years as part of the national At Home/Chez Soi study looking into how better to serve mentally ill people who are chronically homeless.

When The Vancouver Sun first toured the building in January 2011, it was a bit chaotic as residents adjusted to living inside and with each other.

The building is now "hitting its stride," said the ever-optimistic Liz Evans of the Portland Hotel Society, which is running the Bosman for the research study.

"The first year of any project we've ever undertaken is always really difficult," said Evans, whose PHS operates several supported apartment buildings in the Downtown Eastside.

"When I come now it just seems so calm ... There isn't the same level of anxiety, or tension, or stress, or frustration, because people's basic needs are being met."

The tenants live in the equivalent of hotel rooms, with a bed, TV and table, plus a private bathroom.

But what is key in the Bosman is all the in-house services. Meals are served in a communal kitchen area, classes like acupuncture and legal aid are offered, and there is a hallway of one-stop-shopping medical professionals: doctors, nurses, pharmacists, social workers and a psychiatrist.

"The tone of the building is so calm and positive. It's not without its moments of interesting chaos ... but those moments are few and far between now," said building manager Jeff West.

All of that is good news. It is also frustrating, since federal funding for the study expires in March 2013. The lease for the Bosman also ends then.

That leaves the future of the building - and its tenants - uncertain, unless there is a commitment soon by the federal or provincial government to continue to provide funding for the Bosman and its staff.

"That is worrying people here, that they'll be going back to the street or to a poorly run SRO," West said.

LIVES BECOME LESS CHAOTIC

The Vancouver arm of the national study placed 100 people in the Bos-man and 200 in scattered apartments across the city, to determine whether chronically homeless people with a mental illness can stabilize if given a house first and then support services. Preliminary results from the participants' first year in their homes shows they do.

The Bosman residents, Evans said, committed fewer crimes and, as a result of staff intervention, have a better relationship with police.

They are learning how to successfully live inside with other people and there have been no evictions.

People are seeing psychiatrists for mental illness and, in some cases, are living less chaotic lives because they are on psych medication for the first time in decades.

And those advancements mean the participants are relying less and less on expensive crisis services, such as emergency rooms and jail cells.

"At the end of the day, this has a massive (cost) benefit because we are getting people treated for things they wouldn't otherwise be treated for," Evans said.

Dave Maddogg is one of the Bosman's most colourful characters, and has lived in the building since it opened in mid-2010.

That is the longest stretch of time that Maddogg, who had been living in a tent in Surrey, has stayed in the same place for many, many years.

Although he has moments when he misses the solitude of his tent, Mad-dogg said he does feel a sense of belonging and understanding from the Bosman staff. He even started dating one of the other tenants, although sadly, she recently died from a heart attack.

Despite his grief, Maddogg's inquistive and friendly natures shines through in his involvement at the Bosman.

He works part-time in the kitchen preparing meals for the other tenants and also collects recyclable bottles from trash bins.

He even frequents some restaurants in the neighbourhood.

"I've built up friendships and trust, and that's hard to do (downtown)," he said.

Maddogg's HIV has been at undetectable levels since he moved in. He is on anti-depressants for his mental illness. When he injects heroin, he does it in the nurse's room in case there are any complications.

"It has been a very interesting two-and-a-half years - interesting good," he said in his halting speech, before flashing a contagious smile.

"I came in here struggling. And I still struggle with it. Dealing with life is not easy all the time. This place: it can be fantastic one day, you want to destroy everybody the next day."

Despite the fact he is now working, making friends and improving his health, it is unlikely Maddogg could sustain his progress if he lived in a home without services to assist him every day.

Without support, he could certainly end up back on the street.

"If this place wasn't here, I'd be dead, I'd be in jail, or I'd still be in a tent. And I'd be sicker than what I am," he said.

Time is running out

The Portland has the option to extend the Bosman's lease for an extra two years, until March 2015, but cannot sign the agreement until government funding is confirmed.

Evans said she understood the Mental Health Commission of Canada, which is running the study, asked Ottawa to cover the rent for an additional two years and that a decision would be announced before Nov. 30.

That's when the Portland will tell the Bosman's owners if there is enough money to keep the building running.

Even if that rabbit is pulled out of a hat by Friday, Evans has been told Health Canada will not continue to fund the outreach services in the building. Therefore, some type of deal must be struck with the Vancouver Coastal Health Authority, but the solution is unlikely to mirror what is being offered now.

"We will still have to work really closely with Vancouver Coastal Health to figure out a way of partnering to ... provide this level of intensity and support for people. It's not like there is an existing program we can apply to so we can replicate this," Evans said.

"I feel sort of hopeful that they are willing to look at alternative models ... that they are interested in learning from this experience."

Most of the clientele at the Bosman were disinterested - for a variety of systemic reasons - in pursuing medical help for their challenges when they were homeless, or were unable to keep appointments.

Having in-house staff meant the tenants could first build relationships with the medical professionals. Participants could also see the workers when they wanted, instead of being shoehorned into the existing medical system.

Some of the Bosman tenants will not always need this type of flexible care - in fact, 24 of the first 100 have moved on to more independent housing. But many will need these services for a long time, Evans said.

"There is a group of people here who really, really need the intensity and level of support that is provided in this type of setting," she said.

For Maddogg, it is not the four walls of the building that have been his biggest saviour. It is the people inside.

Tenants sometimes speak to each other about their similar pasts, and Maddogg has grown very attached to the workers in the building and the services they offer.

"Without those in place, this place would be nothing ... It would be another dive," he said. "To me this is my home, and I really don't want to move."

THE AT-HOME/CHEZ SOI STUDY

Description: A national research project to find the best way to provide housing and services to people who are living with mental illness and homelessness.

Concept: To provide people with a place to live and then to offer support to address chronic challenges.

Launched: October 2009 by the Mental Health Commission of Canada in five cities: Vancouver, Winnipeg, Toronto, Montreal and Moncton.

Cost: $110 million, funded by the federal government.

Requirement: Participants must hand over the $375 shelter allowance from their social assistance cheques and regularly see project staff.

Study funding ends: March 31, 2013.

VANCOUVER PORTION:

Cost: $30 million.

Focus: People with mental illness and substance abuse.

Participants: 500 (300 with high needs and 200 with moderate needs).

Apartments: 200 placed in apartments scattered across the city.

Bosman: 100 placed together in an SRO-like building.

Control group: 200 monitored but offered no housing or services.

THE SERIES:

Saturday: Meet Melanie Connors, who had a baby while housed by the study.

Researchers reveal how participants have improved but worry about the funding ending.

Monday: Tyson Pappas is one of the 200 members of the control group who receive no help. Researchers argue this study should be expanded to help this group and others on the street.

Tuesday: Troy Pugsley and Chris Larsen live in apartments, and are doing well

with support from study outreach workers.

TODAY: Dave Maddogg has stabilized while living at the Bosman Hotel, but the fate of the study's SRO building is uncertain.

Thursday: Emily Grant discusses her incredible transformation. Other success stories from the study are shared by the mother, employer and landlord of several participants.

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